https://orcid.org/0000-0002-4973-203X
![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Purpose
Studies on the epidemiology of bloodstream infection (BSI) and antimicrobial resistance (AMR) are limited in Vietnam. Thus, the present study aimed to elucidate the epidemiology of BSI and AMR of BSI-causing bacteria in Vietnam.
Methods
Data regarding blood cultures from 2014 to 2021 were collected and analyzed using the chi-square test, Cochran–Armitage test, and binomial logistic regression model.
Results
Overall, 2405 (14.15%) blood cultures were positive during the study period. In total, 55.76% of BSIs occurred in patients aged ≥60 years. The male-to-female ratio of patients with BSI was 1.87:1. Escherichia coli (26.11%), Staphylococcus aureus (15.79%), Klebsiella pneumoniae (10.44%), Acinetobacter baumannii (4.70%), and Pseudomonas aeruginosa (3.45%) were the leading bacterial species causing BSI. The AMR rate of these bacteria isolated in the intensive care unit (ICU) was significantly higher compared with that of those in other wards. E. coli was the least resistant to carbapenems (2.39%–4.14%), amikacin (3.85%), and colistin (11.54%) and most resistant to penicillins (>80.0%). S. aureus was the least resistant to glycopeptides (0%–3.38%), quinupristin-dalfopristin (0.59%), and linezolid (1.02%) and most resistant to clindamycin (71.57%). K. pneumoniae was the least resistant to ertapenem (8.86%), amikacin (9.39%), and colistin (15.38%) and most resistant to aztreonam (83.33%). A. baumannii was the least resistant to amikacin (16.67%) and colistin (16.67%) and highly resistant to other antibiotics (≥50.0%). P. aeruginosa was the least resistant to colistin (16.33%) and piperacillin (28.17%) and highly resistant to other antibiotics (≥50.0%). Notably, the multidrug resistance rate of E. coli (76.41%) was the highest among common pathogens, followed by A. baumannii (71.57%), P. aeruginosa (64.56%), S. aureus (56.99%), and K. pneumoniae (43.72%).
Conclusion
The AMR rate of BSI-causing bacteria, particularly strains isolated from ICU, was alarmingly high. There is a need for new antibiotics, therapeutic strategies, as well as prevention and control to combat BSI and AMR.
Abbreviations
AK, Amikacin; GM, Gentamicin; AMC, Amoxicillin-clavulanate; AMP, Ampicillin; CTX, Cefotaxime; CAZ, Ceftazidime; CIP, Ciprofloxacin; NOR, Norfloxacin; IMP, Imipenem; MEM, Meropenem; ETP, Ertapenem; FOS, Fosfomycin; SXT, Trimethoprim-sulfamethoxazole; AZ, Azithromycin; E, Erythromycin; TE, Tetracycline; LEV, Levofloxacin; MFX, Moxifloxacin; OFL, Ofloxacin; CM, Clindamycin; FOX, Cefoxitin; DO, Doxycycline; RIF, Rifampicin; VA, Vancomycin; TZP, Piperacillin-tazobactam; TOB, Tobramycin; TIM, Ticarcillin-clavulanate; FEP, Cefepime.
Data Sharing Statement
All data used for analyzing and generating the results of this study are included in this article.
Ethics Approval and Informed Consent
This study was approved by the Ethics Committee of Military Hospital 103, Hanoi, Vietnam (Approval No. 35/CNChT- HĐĐĐ). All patient data were anonymized before performing the analysis.
Acknowledgments
We would like to thank the staff of the Microbiology Department, Military Hospital 103, for their contributions.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests in this work.